清肺理痰方治疗痰热夹瘀型慢性阻塞性肺疾病急性加重期临床研究

Clinical study on Qingfei Litan decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease with phlegm heat and blood stasis type

目的观察清肺理痰方治疗痰热夹瘀型慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法将60例痰热夹瘀型AECOPD患者按照随机数字表法分为2组。对照组30例予西医常规治疗;治疗组30例在对照组治疗基础上加清肺理痰方口服。2组均治疗10 d。比较2组疗效;观察2组治疗前后证候积分变化;比较2组治疗前后肺功能指标用力肺活量(FVC)、第1 s用力呼气容积(FEV 1)/FVC、FEV 1占预计值百分比(FEV 1%)变化;比较2组治疗前后血气指标酸碱度(pH)、氧分压[p(O 2)]、二氧化碳分压[p(CO 2)]变化。结果治疗组总有效率96.67%,对照组总有效率73.33%,治疗组疗效优于对照组(P<0.05)。2组治疗后各项证候积分及总积分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后FVC、FEV 1%、FEV 1/FVC均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后p(O 2)较本组治疗前升高(P<0.05),p(CO 2)较本组治疗前降低(P<0.05),且治疗组治疗后p(O 2)升高更明显(P<0.05),p(CO 2)降低更明显(P<0.05)。结论清肺理痰方治疗痰热夹瘀型AECOPD,可明显改善患者痰热夹瘀症状、体征及呼吸功能,效果确切,副作用小。

Objective To observe the clinical efficacy of Qingfei Litan decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with phlegm heat and blood stasis type.Methods 60 patients with AECOPD with phlegm heat and blood stasis type were divided into two groups according to the random number table method.30 cases in control group were treated by routine western medicine.30 cases in treatment group were treated by Qingfei Litan decoction on the basis of the control group.Both groups were treated for 10 days.The curative effect was compared between the two groups.The changes of syndrome integral before and after treatment in two groups were observed.The changes of forced vital capacity(FVC),the first second forced expiratory volume(FEV 1)/FVC,FEV 1%of predicted value before and after treatment were compared between the two groups.The changes of blood gas index,such as pH degree of acid or alkali(pH),oxygen partial pressure[p(O 2)]and carbon dioxide partial pressure[p(CO 2)]before and after treatment were compared between the two groups.Results The total effective rate was 96.67%in treatment group and 73.33%in control group.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).After treatment,the scores of each syndromes and total scores in the two groups were lower than those in the group before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).After treatment,FVC,FEV 1%,FEV 1/FVC in the two groups were higher than those in the group before treatment(P<0.05),and the increase in the treatment group was more significant(P<0.05).After treatment,the p(O 2)of the two groups were increased(P<0.05),the p(CO 2)were decreased(P<0.05),and the increase of p(O 2)in treatment group was more obvious(P<0.05),and the decrease of p(CO 2)in treatment group was more obvious(P<0.05).Conclusion Qingfei Litan decoction can obviously improve the symptoms,physical signs and respiratory function of AECOPD patients with phlegm heat and blood stasis type,which has little side effect.